Voices: The NHS needs immigration – don’t cut non-British staff out of the narrative

·3-min read
The contributions of migrants to our healthcare workforce were recognised as early as 1957 (PA)
The contributions of migrants to our healthcare workforce were recognised as early as 1957 (PA)

The NHS is a national treasure, established to provide healthcare from the cradle to the grave, based on a social contract – a central obligation of the government to the public to keep our nation healthy.

As a nation, we are well aware of the pioneers that paved the way for the formation of the NHS, including William Beveridge’s 1942 report, Clement Attlee’s transformative Labour government, and the Fabian Society, which first called for a national healthcare service in 1911. However, an often untold story is the significance and importance of immigration to our National Health Service’s collective story.

The contributions of migrants to our healthcare workforce were recognised as early as 1957. At the time, 12 per cent of doctors, in a random sample taken between 1953 and 1955, were trained overseas, according to the Willink Committee on medical manpower. These doctors had migrated to Britain during or after the Second World War and were mainly of Jewish and central European ancestry.

The post-Second World War Windrush generation from the Caribbean strengthened the NHS workforce, taking up roles such as nurses and porters. Later, in the 1960s and 1970s, migrants from the Indian subcontinent and African migrants from Kenya and Uganda arrived, taking up primary care and less popular hospital roles.

The positive impact of immigrants on the NHS continues to be felt, with 14.6 per cent of its workforce reporting a non-British nationality. During the height of Covid-19, ethnic minorities working within the NHS put their lives on the line to protect the public, while disproportionately experiencing the negative impact of the pandemic.

The story of immigration and the NHS is larger than the individual negative experience so often portrayed. When one reflects on the pioneering generation of immigrants, a positive story emerges of how a national institution central to Britain’s identity was shaped by immigration.

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Immigration can also play a role in helping with the current workforce crisis experienced in the NHS and social care sectors. The NHS is on track to have a shortfall of 108,000 nurses, while the number of GPs is short of demand, according to the King’s Fund, an independent charitable organisation working to improve health and care in England.

It recommends lifting visa restrictions for non-EU workers to come and work in the NHS and social care sectors. These restrictions have been eased for some non-EU doctors and nurses, but should be extended to other healthcare professionals. However, we must be mindful not to precipitate a brain drain from nations in the global south.

The NHS should also aim to recruit around 5,000 full-time, international nurses a year on average, says the King’s Fund, to get to a 5 per cent vacancy rate target for nurses by 2023-24. It also recommends paying the costs associated with migrating to work in the NHS from the NHS’s central funding. This prohibitive cost can frequently deter international recruits.

But the key to recruiting and retaining staff is for their pay to rise in line with inflation and wider economy earnings to ensure they feel valued.

The NHS forms a core of our national identity, and it is often used when projecting an example to the rest of the world of how we wish others to see our nation. Therefore, we must recognise the crucial foundational role ethnic minorities and migrants have played in the history of our NHS, and reshape our national narrative.

Dr Martin Edobor is chair of the Fabian Society and an NHS GP